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NPI Code Detail

MEDICARE: FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC.

MEDICARE: FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0200XRadiology Clinic/Center
2282N00000XGeneral Acute Care Hospital232; 279WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
25000021OTHERWIUNITED HEALTHCARE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5501166OTHERWIDEAN HEALTH PLAN
6137793700OTHERWIUS DEPT OF LABOR
79000355OTHERWITOUCHPOINT

General Provider Information

NPI Number : 1255334173
Entity Type Code : Organization
Provider Name (Legal Business Name) : FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC.
Provider Business Mailing Address
First Line : N74W12501 LEATHERWOOD CT
Second Line :
City : MENOMONEE FALLS
State : WI
Zip : 53051-4490
Country : US
Telephone Number : 414-777-0417
Fax Number : 414-777-0096
Provider Business Practice Location Address
First Line : 9200 W WISCONSIN AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53226-3522
Country : US
Telephone Number : 414-805-3000
Fax Number : 414-805-7790
Authorized Official
Title or Position : PRESIDENT
Name : AUSTIN REEDER
Credential :
Telephone Number : 414-805-2915
Provider Enumeration Date : 05/24/2005
Last Update Date : 10/03/2025

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